One of the many challenges of women suffering from nausea and vomiting during pregnancy is that they are not able to keep down their prenatal vitamins. Lacking these vitamins, which are necessary for the health of the mom and development of the baby, in turn leads the mom to worry that she is already not giving her baby the best start in life. Rest assured that many of us went on to have healthy babies even without taking our prenatal vitamins, but this is far from an ideal situation. The best option would be to arrange for IV vitamins; however, these are rarely approved by the doctor and insurance company until the mom has been nutrient depleted for many months therefore missing the crucial first nine weeks while the heart and palate are forming. There is also a financial and logistical challenge to receiving nutrients intravenously, so if there is any way possible to take oral vitamins, give it a try. Since there are no clinical studies comparing brands, so here are things to consider:
✓ Look for a brand that has the nutrients in which you are deficient or you will need when HG depletes them. It’s more important to supplement that nutrient, like vitamin B9/folate, vitamin B1/thiamin, vitamin C, D or K, than to try to get take a giant vitamin that will not stay down, may trigger a vomiting series and may even have very low absorption.
✓ If you have a specific diet, choose one which fits your needs, to include dye free, gluten free, vegan, vegetarian, Kosher…
✓ Choose formulations that may be easier to swallow. Options include miniature sized vitamins or gummy formulations. There is even a Mini Prenatal that is covered by some insurances, although your doctor may need to complete a prior-authorization (P/A) form to get that specific national drug code (NDC) covered.
✓ Vitamins with probiotics or vegetable extracts may offer additional support for HG
✓ B1/Thiamin: Unfortunately, none of the over-the-counter (OTC) prenatal vitamins have enough B1/thiamin that would help if you were to become malnourished, so I recommend adding at least 100mg/day in addition to a prenatal. Recommended formulations include lipothiamin, allithiamin or benfotiamine as these cross the blood-brain-barrier easier, but any formulation is better than none.
✓ Vitamin B9/Folate and Vitamin B12/Cobalamin: If you have a family history of neural tube defects (NTD) or are concerned about lacking nutrients that may prevent NTDs, talk to your doctor about taking a prenatal vitamin with the metabolized form of folic acid called folate, methyl folate for l-methyl folate and the metabolized form of cobalamin.
Note: If you see DFE on the label, that means dietary folate equivalents.
Here is my list of recommendations, based on feedback from integrative health practitioners and HG survivors:
💊 Klaire Labs Prenatal and Nursing Formula 90 caps
💊 Davinci Labs Ultimate Prenatal 150 tabs includes digestive enzymes
💊 Optimal Health Optimal Prenatal 60 Chewable tabs include licorice (known to help with nausea and heartburn), xylitol (which helps with constipation), Co-Q10 (known to help with increased fertility and decreased pre-eclampsia).
💊 Smarty Pants received many recommendations as they are gummies and easier to swallow. Be sure to give extra mouth care to your teeth when taking gummies, though, as the sugar can sit and hide in your teeth.
💊 Pure Encapsulations has iron, iodine and choline which are great for those who tend to be anemic or have clotting disorders.
All of these are available through my Wellevate and Fullscript dispensary, but you can also buy them at most health food stores or elsewhere online. Be sure you are ordering from a legitimate source!
Tips and Tricks
✓ Use your health savings plan (FSA or HSA) card when purchasing your prenatal vitamins to get the tax benefit.
✓ Order online and have your vitamins delivered, to avoid having to leave home.
Found a brand that was tolerable and beneficial during your HG pregnancy? Email it to firstname.lastname@example.org so we can add it to our recommended list.